S1C4. Understanding Incest OCD: An Introduction to Taboo Intrusive Thoughts

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Incest OCD: This presentation of OCD is a subtype of Sexual Intrusive Thoughts OCD. As the name suggests, this type of OCD is characterized by intrusive and disturbing unwanted sexual thoughts or mental images involving family members such as parent/sibling/child. The sufferer has a strong fear of having done, doing, or wanting to do something sexually inappropriate with a member of the family. Their affection for their family members may become the reason for their discomfort.

It is important to note that these thoughts are ego-dystonic. This means that these thoughts conflict with the person’s values and intention, and they don’t want to act on their intrusive thoughts. They would, in fact, be repulsed by the thoughts and experience shame, guilt, fear, and disgust for getting these thoughts. These thoughts horrify them, as they might make them feel that they are horrible people for getting these thoughts.

They may engage in compulsions of avoidance, reassurance seeking, mental checking, and neutralizing thoughts.

For a correct understanding of whether such thoughts could be reflective of Incest OCD, the following factors should be considered (adapted from Veale et al., 2009):

  1. Are your thoughts ego-dystonic? (Meaning, your thoughts do not align with your likes, wishes, or desires).
  2. Do you avoid situations that trigger the thoughts?
  3. Do you attempt to suppress or neutralize the thoughts?
  4. What is the dominant emotion you experience when you have the thoughts (e.g., anxiety, distress, or guilt vs. pleasure)?
  5. Do you have other symptoms of OCD?
  6. What other mental disorders do you have?
  7. What is your motivation for seeking help?

In any case, self-assessment alone may not be a wise course of action for an accurate diagnosis, and professional help must be sought. A professional assessment that probes the nature of thoughts and the resultant feelings is very important to arrive at an accurate diagnosis.

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